Nutrition is a complex topic and can be triggering for some of us depending on our background and history. We have information on calorie counting and beach body culture. We also have information on various diets such as ketone, paleo, and fasting. What we know is that our bodies have different nutritional needs and that one diet or way of eating does not fit for all. There is also a real lack of good research into female specific nutrition although thankfully this is changing. So here we will outline the baseline information that will help you make choices around nutrition that are healthy but with the disclaimer that this doesn’t replace speaking to a nutritionalist or dietician who is able to look at you as an individual.
What diet is the healthiest?
There are so many diets out there but time and time again the diet that comes out as being the healthiest for us, is one based on a Mediterranean diet. This means a diet that is rich in fruits, vegetables, pulses, legumes and good fats such as omega -3s from fish and olive oil. It is low on red meat and dairy but nothing is completely restricted.
But in the advent of companies such as Zoe, we can see that we all have unique ways of processing foods and that taking an individual view of our diet is important.
Certainly again another generalisation can be made that it is worth focusing on balance in our diet. That means taking in a balance of carbohydrates, protein and good fats.
What about nutrition across the menstrual cycle?
Our body will have different calories and nutritional needs across the cycle because of changes in hormone levels.
In the luteal phase, in that lead up to our period, there is an increase in our basal metabolic rate. This means we burn more calories with this varying between women but can be a change of up to 300 calories. Progestogen can increase appetite too leading to cravings at this time of the month for many women. We can manage this by reaching for long acting carbohydrates (think whole grains, fruits and vegetables) and good fats (think nuts, avocados and plant based oils) rather than high sugar foods which will often lead to energy crashes throughout the day.
15 to 18 % of women of child bearing age worldwide are iron deficient so another focus with what we are consuming has to be an increase in iron containing foods especially around the time of our period. Iron occurs naturally in our dark green vegetables, soy products, beans, nuts and seeds.
Magnesium supplementation has been shown to reduce premenstrual symptoms such as bloating and it has been found to be particularly helpful in combination with B6. Some of the other B vitamins have also been found to be helpful and these can be found naturally in foods such as seeds, nuts and spinach.
Calcium and vitamin D seem to also play a part in premenstrual symptoms with a higher level in our diet being associated with lower risk of symptoms. Natural sources of these come from our dairy products, non dairy milks, leafy vegetables and fish.
Some women seem to feel the benefit of soy based products at this time of the month but this does not seem to be true of all women and might be worth a try and see approach.
Diet and fertility
The first point here has to be that being pregnant is a big stressor on the body and it is great practice to focus on being as healthy as possible if you are trying to conceive. This means thinking about feeding your body in a nutritious way with a healthy, balanced diet at least 80% of the time. Fertility is a massive issue and nutrition is only one part of this with around 15% of couples experiencing infertility. This healthy, balanced diet will have more plant based sources of protein and unsaturated fats both found to help in fertility.
Every women who is trying to conceive should be taking a supplement of folic acid, to protect their baby from spinal cord defects, and also vitamin D.
Pregnancy, even more than our regular monthly cycle, is associated with anaemia or low iron and therefore thinking about eating a diet that is high in iron or supplementing is a good idea when trying to conceive. Good ways of ensuring we absorb the iron we are consuming is to think about also consuming vitamin C with your meals and avoiding drinking tea or coffee at mealtimes.
Iodine is worth considering as it is essential for fertility and can be lacking in our diet especially as more of us move to being vegetarian or vegan. We get iodine in our diet from dairy products and fish and it may be worth looking for fortified products if you don’t have these in your diet.
Nutrition and Pregnancy
It is worth looking at the above section on fertility to help start the conversation around nutrition during pregnancy as anything associated with fertility will also aid our body during pregnancy. Focusing on a healthy, balanced diet with particular focus on iron, omega -3 ( good fats), iodine and supplementation with folic acid and vitamin D would be the best advice.
There are certain foods that are not recommended when pregnant which can be found easily with a search online. My advice on how to remember the list is to think about how food is prepared. For the most part if food has been pasteurised or cooked then it is ok but if it is raw or under cooked it is best avoided if possible in pregnancy. Another thing to be cautious about is vitamin A which we find in liver and liver pates. The advice now is to avoid alcohol altogether and to limit amounts of caffeine.
If we are having to supplement with iron during pregnancy we can be at high risk of constipation. This is best managed by increasing fluid intake and also the amount of fibre in the diet. This again means whole grains, fruits and vegetables, beans and pulses. Keeping active will help with this. If it is very problematic and starting to cause pain and haemarrhoids from straining then please speak to your midwife or doctor about laxative prescriptions that are safe in pregnancy.
During the post natal phase our bodies are going through a lot of change. Hormone levels will be fluctuating out of any normal cycle and can be hard to predict. Whether you are breast or bottle feeding will have a difference both on these hormonal levels but also specific nutritional needs. But all women will be facing tiredness and physical and emotional changes so it is a good idea to plan for this phase and think about how to give your body the best nutrition possible to help cope with all that your body is doing.
The same healthy diet which we have been learning about, that supports us prenatally and perinatally will help us here too. Focusing on our macro nutrients of long acting carbohydrates, proteins with an emphasis on having some plant based sources, and good fats, is a great place to start. When we are tired we can often reach for more sugary or salty snacks which can lead to more mood and energy crashes. So try and plan for this (or ask supportive partners, families or friends to help) by stocking up on nourishing snacks that will give you sustained energy boosts. It is also worth cooking in bulk if possible and freezing so again it is easier to reach for a balanced meal rather than something that makes us feel more sluggish and drained.
If we are breast feeding our bodies need around a litre more fluid a day and also around an extra 500 calories a day. We require more protein (11g more), calcium (550mg more), omega 3 (200mg more), iodine and vitamin D. So lots of reasons to bring in lots of vegetables, beans, pulses, nuts and seeds to supplement our protein of choice.
Menopause and nutrition
Thankfully there is more and more information available to women in the perimenopause and beyond thanks mostly to the Davina effect and the various professionals who have stepped into the spotlight to highlight the importance of health in women.
Nutrition is one of the main pillars of how we can support our bodies through this transition. By now we know what makes up a nutritious diet but there are some particular areas we can focus on. The drop in oestrogen we have is blamed for the impact on our bone, heart and brain health along with the wide range of symptoms that women experience. So when we think about our diet we are working to support these systems as much as possible.
When we think about cardiovascular health then it can be good to reduce our intake of saturated fats and really think about increasing our good fats such as nuts, plant based oils and avocados. It is also worth cutting back on our red meat intake and salt and increasing our intake of oily fish or plant based fatty acids. Increasing our intake of oats, nuts and soy products have been shown to improve our lipid profile which in turn reduces our cardiovascular risk.
Increasing our intake of whole grains and eating the rainbow can improve the health of our gut and increase antioxidants in our system, the stuff that mops up toxins from our body caused by pollutants and stress.
Bone health can be improved by thinking about our intake of calcium and vitamin D. The best way to get vitamin D is through daylight but if you have dark skin or spend most of the day indoors then you are likely to be lacking your recommended amount. Many people have to supplement through the winter in the UK because they know that their levels drop and they can feel the impact on their whole body. Natural sources of calcium and vitamin D are dairy products and fortified non dairy equivalents such as oat milk and soy milk. Our flour in the UK is fortified as are some juices. Tinned fish, tofu and seeds are other sources and we can get some vitamin D from eggs, mushrooms and liver.
Protein intake is important at this phase of life too to help protect our muscular and nervous system which is so important. It can be helpful to think about getting protein at every meal and to go with what you enjoy. You will find you stay fuller for longer too which can help with weight management which can be a problem in the menopause.
Magnesium is a micronutrient getting more coverage recently, particularly with regards to our musculoskeletal system, and is something that we can be lacking in our diet. Sprinkling some mixed seeds on our oat based breakfast can be a really tasty way to increase our intake alongside nuts and even dark chocolate.
Hopefully this has given you some food for thought! Time and again no matter what phase of life we are in, the message is the same. A healthy, well balanced diet will be one that contains all the important food groups. When thinking carbohydrates, think about the longer acting types more than the short acting sugary ones. When thinking of protein try to make that plant based at least 2 or 3 times a week. When focusing on fats, think about cutting back on saturated fats and increasing those good fats like seeds, nuts, plant oils and avocados. Try and cut back on processed foods and to eat the rainbow. With all of that in mind it is hard to go wrong!